[Monitoring of neuromuscular block by acceleromyography: concepts, applications and limits of use]

Abstract

A recent survey among French anesthesiologists revealed that monitoring of curarization is used in approximately in 50% of cases after a unique dose of curare and in 75% of cases after repeated doses of curare. In this survey, a majority of clinicians used a quantitative monitor based on acceleromyography, i.e. that the majority of clinicians used a device from the TOF-watch(®) product line. Results obtained by these monitors depends on the model used, TOF-Watch(®), TOF-Watch S(®) or TOF-Watch SX(®), as well as if it is used for a single point measurement at the end of the operation or continuously throughout the operation, with or without calibration, and if a calibration is used, should we used Cal 1 or Cal 2? Technical specifications and their impact on results will be developed in this technical note. This will help clinicians to better interpret results obtained by TOF-watch(®) monitors in order to improve clinical decisions based on monitoring of neuromuscular transmission.